Mr. Lickenby occupied most of the evening in concluding his practical demonstration of preparing and mounting insects in balsam. A general summary of his methods was given in the report of April 10th, but some special points were brought out last evening which are of interest to those engaged in this branch of the study. It is quite difficult, in preparing many of the smaller forms of insects, to remove the debris from the surface of the specimer. without injuring the delicate portions. This the gentleman accomplishes by the aid of albumen, flowing the white of an egg over the object and immersing the slide in hot water till the albumen is coagulated, when it will generally crack open and may be removed in two portions, carrying with it all the foreign matter and leaving the surface of the specimen perfectly clean. Another thing strongly advocated is thorough washing of the objects in running water and a final rinsing in either filtered or distilled water before placing in alcohol.

In mounting, the insect is placed under the cover glass arranged in proper shape, the clearing solution applied, and when sufficiently transparent the oil of cloves is drained away and Canada balsam introduced at one edge of the cover glass, the slide being held over the flame of a lamp to gently warm the balsam and allow it to flow in and displace the remaining oil of cloves. No annoyance need be felt at the appearance of bubbles of air, as they will all gradually disappear. The mount, when filled with balsam, is placed in a warm oven or incubator and kept at a temperature of from 120° to 130° Fahrenheit for twenty-four hours, when the balsam will be thoroughly hardened and all the air bubbles driven out.

Mr. Lickenby does not advocate the use of volatile solvents with balsam, he being convinced that a certain amount of gas is always retained in the mount in a latent state, requiring only a slight amount of heat to produce bubbles and disfigure the specimen. The outer skeleton of insects is composed of a substance called chitine, which is quite unique in its chemical composition. It appears to be, within certain limits, very resistant to acids and alkalis, and it is owing to this fact that caustic potash can be used in such varying proportions in treating them for microscopical study. It is said, however, that chitine succumbs to the action of chlorine compounds, which would render that substance unfit for use in bleaching many of the delicate forms.

The members of the Society are strongly in favor of these

practical demonstrations, and quite a discussion of the matter was indulged in, the result of which may be the inauguration of a movement that will tend greatly to arouse the zeal and add to the effectiveness of future microscopical work.

Before adjourning the Society tendered Mr. Lickenby a hearty vote of thanks for his skillful and instructive demonstrations.

Gleanings.

MAMMARY TUMORS-THE IMPORTANCE OF EARLY DIAGNOSIS AND EARLY REMOVAL. -Dr. W. B. Rogers, of Memphis, (Memphis Jour. Med. Sci., May, 1889), shows the importance of early diagnosis of tumor of the breast. The world needs to be educated to the fact, that malignant growths, early and thoroughly extirpated, in many instances never return; that cancer of the breast is primarily a local and not a constitutional disease; that early removal sometimes saves a life, prolongs many lives and shortens but few. All tumors of the mammæ are either cystic or solid. Three varieties of cystic growths are found:

1. Retention cysts-due to occlusion of a duct with constant accumulation, causing dilatation of milk vesicles and ducts, the walls of which form the cyst wall; such a cyst contains milk, with occasional accidental hemorrhage.

2. Exudation cysts--the dermoid cyst.

3. Adventitious cysts, or new formed cysts-whose walls are formed by the hypertrophy of dilated connective tissue spaces. Such cysts contain ecchinococci, pus as in the cold abscess, or a serous fluid coming from the blood-vessels and lymph spaces of the part. Of the solid variety we find four:

1. Adenoma; 2. Fibroma; 3. Epithelioma - carcinoma in one of its types; 4. Gumma. The sense of fluctuation on palpation is the test most generally used to tell a cystic from a solid growth. But aspiration is the best method of diagnosis.

Adventitious cysts-new formed cysts whose walls consist of hypertrophied connective tissue space walls—are of three varieties:

a. Ecchinococci-Aspirator reveals fluid containing ecchi

nococci.

b. Cold abscesses--Aspirator reveals pus.

c. Simple and compound cysts—Aspirator reveals serous fluid; clear or opaque, yellow, red or brown.

Retention cysts-galactoceles--occur only during lacteal period; aspirator detects milk. Considered as a whole,

infant cystic tumors of the mamma are non-malignant. Dermoid cysts are to be excised.

Ecchinococci cysts are to be incised, curetted and drained till healed.

Cold abscesses are to be incised, curetted and drained till healed.

The galactocele is incised, or punctured and drained, while the functional activity of the gland is depressed.

Adipoma is a diffuse hypertrophy of the normal fatty elements of the organs.

Adenoma is a circumscribed hypertrophy of the secret-` ing portion of the organ.

Fibroma is a circumscribed hypertrophy of fibrous tissue. Carcinoma is a circumscribed induration fixed in the substance of the gland.

Gumma is a syphilitic deposit.

Dr. Rogers confesses a disbelief in any positive reliable diagnostic point between a fibroma, adenoma and carcinoma, in their infancy.

Every solid tumor of the breast ought to be extirpated in company with the entire gland, most of the skin covering the gland, the pectoral facia; the connective tissue, fat and lymph structures of the axilla. Since 90 per cent. of tumors sooner or later develop malignancy, the course to pursue is complete extirpation of the gland, with the one exception, galactocele.-Va. Med. Monthly.

CAUSES AND PREVENTION OF PUERPERAL SEPTICEMIA is the title of a paper by Dr. J. M. Pace (Tex. Cour. Rec. Med., April, 1889). Adopting Lusk's definition of the disease, he rapidly sketches the literature on the subject from the days of Hippocrates down to the present time. The idea as to the importance of rendering the atmosphere aseptic is not now adhered to. He believes Paget struck the key-note in asserting that aseptic surgery is clean surgery. The belief that puerperal septicemia was caused by the absorption of septic matter through the lesions of the genital tract was first advanced by Semmelweis in 1847, and is now no longer disputed. Crede's summary of the prevention

of puerperal fever under two heads is a good one: I. "Prevent as far as possible the lesions of the genital tract." 2. "Prevent the infection of the lesions that are inevitable." Under the first head all improper positions should be corrected and few vaginal examinations should be made. He holds that the sack containing the liquor amnii should remain intact until spontaneously ruptured, unless there are good reasons for an earlier interference. Under the second heading comes the strict observance of utter cleanliness and the non-interference with the uterine cavity after labor unless the temperature suddenly rises and remains so for twenty-four hours, when uterine douches may be used and an iodoform suppository introduced.-Va. Med. Monthly.

REMOVAL OF A FOREIGN BODY FROM THe Bladder.--Dr. W. T. Briggs, of Nashville, Tenn., reports (Nashville Jour nal of Medicine and Surgery, April, 1889,) the case of a man who introduced a cylinder of steel about an inch and a half in length and a quarter of an inch in diameter into his urethra for the purpose of "cooling an irritable spot" and went to sleep. When he awoke it had escaped into the bladder. The usual symptoms of the presence of a foreign body in the bladder soon manifested themselves. A small lithotrite was introduced, the body was seized and removed. The success of this manœuvre was due to relaxing the grasp of the instrument upon the body after firm traction had drawn it to the vesical opening of the urethra, thus permitting the cylinder to be pressed upon by the surrounding parts into a line with the instrument.

PROLAPSUS UTERI.-In the Nashville Journal of Medicine and Surgery, April number, Dr. W. L. Nichol, of Nashville, Tenn., after describing the natural supports of the uterus, details the operation by himself on a case of thirteen years' standing. It was a case of extreme prolapsus; the uterus was enlarged, the perineum destroyed, and after replacing the womb, the vagina was found to be treble its proper size. The patient being placed in the extreme lithotomy position, the mucous membrane of the posterior wall of the vagina was hooked up and stitched. This strip of mucous membrane was then dissected off with a pair of scissors and terminated in two arms on either side of the womb. The edges of the denuded structure were then stitched together with interrupted sutures of catgut, thus greatly diminishing the size of the vagina. The womb was then restored to its

normal position and the perineum was restored by sutures extending throughout its entire depth. Lastly he supplemented his work by adding Alexander's operation. The result was good both to primary union and thorough sustenance of the organ.

MALIGNANT TUMOR OF THE KIDNEY AND SUPRA-RENAL CAPSULE. In Progress, April, 1889, Dr. J. H. Grone writes the history of a woman who died from tumor of the kidney and supra-renal capsule. On February 15, 1888, she had a tumor removed from the right axilla and made a good recovery. In October following she began to complain of pain in the loins and left side. On December 27 she was admitted into St. Agnes' Hospital, being greatly emaciated and markedly cachectic. Physical examination revealed a tumor occupying the left half of the abdomen. It was quite fixed, and upon palpation was found to be firm, until three weeks before death, when it became soft. Red blood corpuscles and hæmoglobin were diminished in the patient's blood. Urine normal. Died March 13. At the post-mortem, the tumor was found to extend from two inches below the diaphragm to three inches above the brim of the true pelvis. The spleen was attached to the apex of the tumor. The kidney was in the lower segment of the tumor and enveloped in its covering. It seems to have sprung from the renal capsule-that organ being the seat of a large cyst filled with grumous fluid and fatty disintegrated debris.

SUB-ACUTE CEREBRO-SPINAL INFLAMMATION, THE RESULT OF CONCUSSION.--On September 20, 1888, L. K., aet. 55. by occupation a collector, was run down by a rapidly driven horse, thrown violently upon the cedar block pavement, and received an incised wound over the left eye, a contusion on the cranium to the right of the occipital protuberance, and bruises on the back and hips. In four days the patient had resumed his occupation, and worked until the morning of October 19th. On rising from the bed he discovered that he could not maintain his equilibrium, and he dragged his left leg when walking, although he suffered no pain. There were no points of tenderness over the spine, although pressure over the contusion on the cranium produced pain. Pulse 55, no ataxic symptoms, reflexes normal. Arcus ænilis well developed before injuries received. During the few days following there were progressive symptoms of disorder of powers of co-ordination, and sub-acute cerebral inflamma